Restoring normoglycaemia by use of a very low calorie diet in long- and short-duration Type 2 diabetes

Diabet Med. 2015 Sep;32(9):1149-55. doi: 10.1111/dme.12722. Epub 2015 Feb 26.

Abstract

Aims: To establish whether an 8-week very-low-calorie diet could improve glycaemic control in Type 2 diabetes of long duration.

Methods: A total of 29 people with Type 2 diabetes [short-duration group (diabetes duration < 4 years), n = 15; long-duration group (diabetes duration > 8 years), n = 14] completed an 8-week very-low-calorie diet, with assessments of fasting anthropometry, blood tests and blood pressure at baseline and weeks 1, 4 and 8 of the diet.

Results: Similar weight loss was achieved in the short- and long-duration groups (14.8 ± 0.8% and 14.4 ± 0.7% respectively; P = 0.662). The glucose response to acute calorie restriction was heterogeneous in the long-duration group with some responding similarly to those in the short-duration group, some responding, but only slowly, and others not responding at all. Overall, HbA1c concentration in the short- vs. long-duration groups fell to 44 ± 2 vs. 64 ± 6 mmol/l (6.2 ± 0.2 vs. 8.0 ± 0.5%; P = 0.002). Fasting plasma glucose levels decreased to 5.8 ± 0.2 vs. 8.4 ± 1.1 mmol/l (P = 0.024) respectively. A total of 87% of the short-duration group and 50% of the long-duration group achieved non-diabetic fasting plasma glucose levels at week 8. Clinically significant improvements in blood pressure and lipid profile were seen regardless of diabetes duration.

Conclusion: In people with Type 2 diabetes of > 8 years' duration, a therapeutic trial of a very-low-calorie diet may be undertaken with a 50% chance of achieving non-diabetic fasting glucose levels off all antidiabetic therapies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Blood Glucose / metabolism*
  • Caloric Restriction / methods*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Fasting / blood
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypertension / prevention & control
  • Hypoglycemic Agents / therapeutic use
  • Lipid Metabolism / drug effects
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome
  • Waist Circumference / physiology

Substances

  • Antihypertensive Agents
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents